Nurses across the National Health Service in England have voted resoundingly to reject the 5.5 percent pay award for 2024-5 by the Labour government.

The Royal College of Nursing (RCN) announced the result of its online referendum on Monday, reporting, “A record 145,000 members voted cast a vote with two-thirds (64%) of them saying they didn’t accept the 5.5% award.”

The pay award was confirmed in late July by Labour Chancellor Rachel Reeves in line with the recommendation by the NHS Pay Review Body (PRB). The rejection of the award by over 90,000 nurses, frontline staff widely respected by the public, is a clear rebuttal to the entire Labour government.

The results were announced on the same day Reeves delivered her high-profile speech to the Labour Party conference claiming to be “proud to stand here as the first Chancellor in 14 years to have delivered a meaningful, real pay rise to millions of public sector workers.”

This was meant to gloss over the reality of the austerity measures already implemented by Labour, including keeping the two-child benefit cap and scrapping winter fuel payments for around 10 million pensioners—a downpayment on what is to come in the next month’s Autumn budget.

The nurses’ vote cut across this false narrative, which is based on pay deals calibrated to be above the immediate rate of inflation in exchange for trade union leaders suppressing all strike action to claw back more than a decade of real terms pay cuts.

Nurses have experienced a decline in wages of 25 percent between 2010 and 2024. The RCN press release announcing the rejection vote, however, stated that the pay award would proceed regardless because, “As this is a pay award rather than a pay offer, the results of our consultation will not directly affect employers’ payment of it.”

The vote to reject was based on a larger turnout than the two statutory votes for industrial action the RCN held in 2022 and 2023, which led to the first ever national strike by the organisation in its 106-year history. But the RCN made clear it has no plans to ballot for industrial action. Whereas under the Conservative government trade unions felt compelled to take strike action against the paltry recommendations of pay review bodies, with Labour in power the RCN is making the case that they cannot be challenged by their members.

The Labour government is relying on the services of the trade union bureaucracy to get the sellouts over the line, with the NEU, the largest teachers’ union recommending the 5.5 percent in a ballot with the result due next week. All other teaching unions have accepted.

The nurses’ vote is testimony to the determination to fight to reverse the betrayal they suffered last year under the leadership of RCN General Secretary Pat Cullen. The media built up Cullen as a militant who had led nurses strikes in Northern Ireland and used identity politics to promote the new female face of trade union leaders who would hold the Sunak Tory government to account.

The sellout which followed involved a staggering low pay award of 5 percent for 2023-4, and a lump sum payment for the previous year, that was backed by Cullen and the RCN leadership against the official demand for 19 percent. The dispute ended in June after 8 days of stoppages and when a renewed mandate failed to clear draconian anti-strike legislation. It saw a petition in March by RCN members for a no confidence vote in Cullen and the executive, which was spiked by the bureaucracy in a vicious witch-hunt during which the police were called in.

This was the worst of all the pay awards within the NHS, but it was carried out within the template of sub-inflation deals set down by all the main health unions.

Cullen, who stood down earlier this year, has been replaced by Professor Nicola Ranger as general secretary. The RCN press release cited Ranger holding talks with ministers at the Labour Party conference about the “consultation results.”

RCN members are again faced with double dealing and empty prattle about nurses being “valued”. Ranger was at the conference to warn the government its continued policy of pay restraint threatened opposition to its overhaul of the NHS which she had the gall to declare was supported by nurses.

Ranger, in a letter to Labour health secretary Wes Streeting on the result of the pay referendum, stated, “Many will support the new government’s health and care agenda as set out in recent weeks and fully recognise the diagnosis of a failing NHS. Working closely with all other professionals, nursing staff are the lifeblood of the service. The government will find our continued support for the reforms key to their success.”

Streeting had arrogantly stated the previous week that the health unions should stop their “sabre rattling” over pay, insisting that the bureaucracy bring their membership into line. The government’s derisory pay award is part of its agenda not for a “reform” of the NHS but bleeding it dry through the rationing of funding, extending privatisation and demanding more overtime and ramped-up productivity.

The nurses’ pay award rejection comes after the Labour government acted to urgently bring an end to the one outstanding national dispute in the NHS, by junior doctors (now referred to as resident doctors). This was to prevent any reigniting of the NHS strike wave of 2022-3 against the new government’s own brutal agenda. The BMA junior doctors committee endorsed the sellout agreement.

Ranger has now stated that the RCN wants to see nurses “treated as fairly” as resident doctors have been with their pay settlement. The 22.3 percent pay deal for two years between 2023-5 can be compared favourably only because of the 5 percent rout overseen by the RCN for nurses, and the efforts by all the health unions to prevent a unified struggle. The BMA deal with the Labour government has left its members 20.8 percent behind in terms of real wages compared to 2008.

In Scotland the RCN, Unite and Unison have already contrived to get through the 5.5 percent pay award for 2024-5. RCN Scotland reported on its ballot for the deal that just over half the eligible voters participated, returning a 61 percent majority to accept while “A significant minority voted to reject the offer, a demonstration of continued frustration and concern about the nursing workforce crisis facing Scotland’s NHS.”

The Socialist Worker article on the vote by nurses in England aims to cover-up why this has been an isolated example, providing only a footnote on acceptance in Scotland without a word of criticism of the RCN, or Unison or Unite which both recommended the rotten pay deal.

It declared instead that “Unison has been engaged in a series of important fights over pay banding. It has already won thousands of big pay rises, with back pay of up to five years” and that “The anger that drove the recent waves of NHS strikes still exists—and may well blow up in Labour’s face.”

The Socialist Worker even cited Ranger’s letter to Streeting approvingly, in which she hypocritically stated that nursing staff were standing “up for themselves, their patient and the NHS” even as the RCN sits on any ballot for action.

Such apologias for the bureaucracy must be rejected in waging a rebellion by rank-and-file nurses and all NHS workers against the union apparatus, now transforming its sellout of the strike wave under the Tories into a corporatist set-up with the Labour government based on privatisation and the dismantling of the NHS.

The demand for a genuine pay increase and protecting the NHS is incompatible with support for a Labour government dedicated to supporting the genocide in Gaza and escalating NATO war against Russia in which there is no restraint on public expenditure. RCN members should demand the holding of a national ballot on industrial action to take forward a fight which would serve as a focal point for a broader fightback.